Pre-Commencement Damage Report Form

PRE-COMMENCEMENT DAMAGE REPORT FORM

Important Information - Please read

Prior to undertaking approved works within the Public Road Reserve, it is necessary to lodge a report to clearly indicate the condition of all assets within the Road Reserve in the area of the worksite that could be impacted by the works. The report needs to clearly indicate any defects with the assets prior to the commencement of approved work (this includes demolition). When the approved works have been completed a final report is to be lodged indicating the condition (including defects) of all assets captured in the original report lodged prior to commencing the approved works, to allow the comparison of defects before and after the approved works have been undertaken.

Please Note: This form will provide a record of damage to your driveway crossover, footpath and kerb & gutter prior to demolition and/or work commencing. This will ensure that when Council returns your bond you will not be penalised for pre-existing damage.

For further information or questions regarding this form, please contact Council via 9911 6555.

Application

The Application fee is as per Council's Fees and Charges.

Application Type: *

DA/CDC related applicationNon DA/CDC application

Please provide application number:

Please provide a ‘Driveway Location’ or ‘Civil Works in the Public Domain’ application number:

Applicant Details

Surname *

First Name *

Address *

Suburb *

Postcode *

Email *

Phone (work):

Phone (mobile): *(e.g. 04XX XXX XXX)

Phone (home):(e.g. (XX) XXXX XXXX)

Site Details

Site Address: *

Site Suburb: *

Site Postcode: *

Remarks

Supporting evidence

Please provide date stamped photographs of all areas with cracks and/or damage BEFORE any works commence. There are date stamping apps that can assist with this if taking photographs on your mobile phone. Alternatively, Council will accept photos that are signed and dated by the applicant. All photos must be current and taken prior to works commencing. These must accompany the lodgement of this application for proper assessment of any pre-existing damage.

It is preferred that you include the following examples:

Full frontage of existing dwelling (prior to works commencing)
individual photos of any existing damage

Supporting evidence (1) *

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Supporting evidence (2)

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Supporting evidence (3)

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Supporting evidence (4)

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Supporting evidence (5)

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Supporting evidence (6)

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Applicant declaration

I declare that all of the information provided on this application is known to be true and correct.

Applicant Signature *

Draw signature|Type signatureClear

Date signed *

Rams - DamageRep

(For Internal Use Only)

DamageRp2